Prognostic Value of Preoperative Systemic Immune-Inflammation Index in Patients with Cervical Cancer

Huaping Huang,Yawei Wu,Yan Zhang,Xiaojuan Lu,Lixia Zhu,Li Liu,Qin Liu

doi:10.1038/s41598-019-39150-0

Abstract

The systemic immune-inflammation index (SII) based on peripheral lymphocyte, neutrophil and platelet counts has been considered a good index that reflects the local immune response and systemic inflammation. However, the use of the SII has not been reported in cervical cancer. In this study, Kaplan-Meier survival analysis showed that a high SII was associated with poor prognosis in cervical cancer patients in the primary and validation cohorts. A higher SII had a significant correlation with larger tumours but had no correlation with other clinicopathological parameters. Among all systemic immune indexes, the SII is the only independent prognostic factor for cervical cancer patients. Compared with the area under the curve for the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR), the area for the SII was larger at 3 and 5 years. In addition, the SII still retains it prognostic values across all FIGO stages. The SII can independently predict the overall survival of patients with cervical cancer receiving radical resection and is thus superior to existing systemic inflammatory indexes. The prognostic nomogram based on the SII is a reliable model for predicting the postoperative survival of patients with cervical cancer.

Highlights

≤45 >45 Histological grade G1 G2 G3 Tumor size ≤4 >4 Lymph node metastasis Negative Positive Lymphovascular invasion No Yes FIGO stage IA IB IIA
Univariate Cox regression analysis was performed for the clinicopathological parameters and systemic immune indexes included in Table 2, and the results showed that the tumour size, lymph node metastasis, lymphovascular invasion, FIGO stage, systemic immune-inflammation index (SII), TRL, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) had a statistically significant effect on the survival time of patients with cervical cancer
After baseline adjustment of univariate indexes, multivariate analysis was performed, and the results revealed that the SII, lymph node metastasis and FIGO stage were independent prognostic factors for cervical cancer patients

Summary

Introduction

≤45 >45 Histological grade G1 G2 G3 Tumor size ≤4 >4 Lymph node metastasis Negative Positive Lymphovascular invasion No Yes FIGO stage IA IB IIA. The value of systemic inflammatory indexes, including the SII, NLR, PLR and MLR, in predicting the prognosis of patients with cervical cancer was evaluated in two independent cohorts. Univariate Cox regression analysis was performed for the clinicopathological parameters and systemic immune indexes included, and the results showed that the tumour size, lymph node metastasis, lymphovascular invasion, FIGO stage, SII, TRL, NLR, PLR and MLR had a statistically significant effect on the survival time of patients with cervical cancer.

Results

Conclusion